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Clinical Chemistry > TDM > Flashcards

TDM Flashcards

1
Q

Highest concentration of drug in the blood; occurs when absorption/distribution exceeds metabolism/excretion

A

Peak

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2
Q

Lowest concentration of drug in the blood; achieved just before the next dose

A

Trough

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3
Q

Time required for drug concentration to decrease by half

A

Half-life

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4
Q

State where drug absorption/distribution equals metabolism/excretion, typically after 5-7 half-lives

A

Steady state

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5
Q

Lowest drug concentration in the blood that produces adverse response

A

MTC (Minimum Toxic Concentration)

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6
Q

Lowest drug concentration in the blood that produces desired effect

A

MEC (Minimum Effective Concentration)

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7
Q

Range between MEC and MTC that produces therapeutic effect

A

Therapeutic range

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8
Q

Drug dose that produces beneficial effect in 50% of the population

A

ED50 (Effective Dose 50)

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9
Q

Drug dose that produces adverse effect in 50% of the population

A

TD50 (Toxic Dose 50)

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10
Q

Drug dose that causes death in 50% of individuals

A

LD50 (Lethal Dose 50)

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11
Q

Therapeutic index is the ratio that indicates drug safety margin

A

TD50 to ED50

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12
Q

Analytical technique that uses Rf values for semi-quantitative screening

A

Thin-layer Chromatography

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13
Q

Formula for Rf

A

distance migrated by sample component/distance migrated by solvent

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14
Q

Technique for insufficiently volatile and thermolabile compounds; mobile phase is liquid passed over stationary phase in the column

A

Liquid Chromatography

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15
Q

Type of liquid chromatography with liquid mobile phase and stationary phase in a column

A

HPLC (High-Performance Liquid Chromatography)

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16
Q

Liquid chromatography with polar stationary phase and nonpolar mobile phase

A

Normal-phase LC

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17
Q

Liquid chromatography with nonpolar stationary phase and polar mobile phase

A

Reverse-phase LC

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18
Q

Chromatography method for volatile or easily volatile compounds, including organic molecules and many drugs

A

Gas Chromatography

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19
Q

Time it takes for a compound to elute; used for solute identification

A

Retention time

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20
Q

Measurement proportional to the amount of solute present; used for quantification

A

Peak area or Height

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21
Q

Common detector system in GC or HPLC for solute identification and quantification

A

Mass spectrometry

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22
Q

Immunoassay using microparticles as solid phase, enzyme label, and fluorogenic substrate; heterogeneous assay

A

Microparticle enzyme immunoassay (MEIA)

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23
Q

Homogenous immunoassay where enzyme activity as a label is inhibited by antibody binding to antigen-enzyme conjugate

A

Enzyme-multiplied immunoassay technique (EMIT)

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24
Q

Homogenous immunoassay using polarized light; rate of rotation is inversely proportional to polarization degree and analyte concentration

A

Fluorescence polarization immunoassay (FPIA)

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25
Q

Drug activity or fate in the body, influenced by absorption, distribution, metabolism, and excretion

A

Pharmacokinetics

26
Q

Biochemical and physiological effects of drugs and mechanisms of action, including receptor binding

A

Pharmacodynamics

27
Q

Measure: Amount of drug absorbed relative to the quantity given; affected by first-pass metabolism

A

Bioavailability

28
Q

Factor affecting absorption of orally administered drugs through the GI tract

A

Bioavailability and first-pass metabolism

29
Q

Factor determining drug distribution into interstitial and intracellular spaces

A

Lipid solubility of the drug

30
Q

Primary site and enzyme system for drug metabolism

A

Hepatic microsomes via cytochrome P450 system

31
Q

Methods of drug excretion

A

Hepatic or renal clearance, or a combination

32
Q

Requirement before drug sampling for accurate analysis

A

Steady state (5-7 half-lives)

33
Q

Specimen type preferred for most drug assays

34
Q

Specimen type suitable for most drugs except Lithium and free drug assays

A

Heparinized plasma

35
Q

Reason SST and PST tubes may falsely decrease TCA and anti-arrhythmics

A

Drug absorption by the gel

36
Q

Specimen type appropriate for immunosuppressant drugs

A

EDTA whole blood

37
Q

Specimen type for aspirin determination via impedance method

A

Hirudin (from leech)

38
Q

Time for collecting trough specimens

A

Before the next dose is administered

39
Q

Sampling guideline when drug toxicity is suspected

A

STAT sampling

40
Q

Cardioactive drugs for treating CHF

41
Q

Mechanism of action for digoxin

A

Inhibits Na+-K+-ATPase, decreasing intracellular K+ and increasing intracellular Ca2+ for improved cardiac contraction

42
Q

Lidocaine, Quinidine, Disopyramide, Procainamide class of TDM

A

Class I antiarrhythmic drugs (Sodium channel blockers)

43
Q

Metabolite of Lidocaine that enhances toxicity

A

Monoethylglycinexylidide (MEGX)

44
Q

Metabolite of Procainamide with the same physiologic effect as the parent drug

A

N-acetylprocainamide (NAPA)

45
Q

Propranolol is an example of

A

Class II antiarrhythmic drugs (Beta blockers)

46
Q

Amiodarone is an example of

A

“Class III antiarrhythmic drugs (Potassium channel blockers)
“Verapamil is an example of”,”Class IV antiarrhythmic drugs (Calcium channel blockers)”
“Treatment for tachyarrhythmias”,”Antiarrhythmics”
“First-generation anticonvulsants for grand mal/tonic-clonic seizure”,”Phenobarbital

47
Q

Inactive form of phenobarbital

48
Q

Antiepileptic for petit mal/absence seizures

A

Ethosuximide, Valproic acid (Depakote)

49
Q

New generation anticonvulsants

A

Tiagabine, Vigabatrin, Gabapentin, Topiramate, Felbamate

50
Q

Bronchodilator used for asthma and COPD

A

Theophylline

51
Q

Minor metabolite of theophylline; treatment for neonatal apnea

52
Q

Neuroleptics (major tranquilizers) for schizophrenia

A

Phenothiazines (chlorpromazine), Butyrophenones (haloperidol), Newer drugs (risperidone, olanzapine, quetiapine, aripiprazole)

53
Q

Antimanic agent for bipolar disorder

54
Q

Tricyclic antidepressants

A

Amitriptyline, Imipramine, Doxepin

55
Q

Selective serotonin reuptake inhibitors (SSRIs)

A

Fluoxetine (Prozac)

56
Q

Monoamine oxidase inhibitors (MAOIs)

A

Clorgyline, Selegiline

57
Q

Antibiotics used for gram-negative bacterial infections; causes nephrotoxicity and ototoxicity (TOGAK)

A

Aminoglycosides (tobramycin, gentamicin, amikacin, kanamycin)

58
Q

Used for gram-positive bacterial infections; may cause Red Man Syndrome (erythemic flushing of extremities)

A

Vancomycin

59
Q

Immunosuppressants: Block T lymphocyte function; Cyclosporine is fat-soluble, Tacrolimus is 100x more potent than Cyclosporine and associated with thrombus formation

A

"”Calcineurin inhibitors (Cyclosporine

60
Q

Immunosuppresant that is proliferation signal inhibitors

A

Sirolimus (Rapamycin), Everolimus, Mycophenolate, Leflunomide

61
Q

Antineoplastic: Inhibits DNA synthesis; requires Leucovorin administration to rescue host cells

A

Methotrexate

62
Q

Antineoplastic: alkylating agent used to treat leukemias and lymphomas before bone marrow transplantation

Clinical Chemistry (43 decks)

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